Step-by-Step Initial Treatment Step 1: Ensure Safety and Assess the Situation • Check for Danger: Make sure the area is safe for you and the victim (e.g., traffic, fire, falling objects). • Call for Help: If the person is seriously injured, has multiple fractures, or is unresponsive, call emergency services immediately. • Do Not Move the Person: Unless there is an immediate threat to life (e.g., a burning vehicle), avoid moving the victim. Moving someone with a possible spinal or neck injury can cause permanent paralysis. Step 2: Perform a Primary Survey (Check for Life-Threatening Issues) Follow the DRSABCD protocol: • Danger: Ensure the scene is safe. • Response: Check if the person is conscious. Tap their shoulder and ask, “Are you okay?” • Send for Help: If unresponsive, call emergency services. • Airway: Make sure the airway is clear. • Breathing: Check for normal breathing. • CPR: If the person is not breathing, start CPR if trained. • Defibrillation: Use an AED if available and required. Step 3: Look for Signs of a Fracture Once life-threatening issues are managed, check for: • Deformity: Limb looks bent or in an abnormal position. • Swelling and Bruising: Around the injured area. • Inability to Move the Limb: Movement is extremely painful or impossible. • Visible Bone: Bone protruding through the skin (open/compound fracture). • Grating Sound: A grinding sensation when the limb is touched or moved (crepitus). • Severe Pain and Tenderness: Especially with movement. Step 4: Provide General Care for the Fracture 1. Control Bleeding and Cover Wounds (For Open Fractures) • Apply gentle pressure around the wound, not on the exposed bone. • Cover the wound with a sterile dressing or clean cloth. • DO NOT attempt to push the bone back inside. 2. Immobilize the Injury • Prevent movement of the broken bone and the joints above and below it. • Use available materials such as a board, rolled newspaper, stick, or even an umbrella as a splint. • Pad the splint for comfort using cloth or towels. • Secure the splint with bandages or strips of cloth—tight enough to hold but not cut circulation. 3. Apply a Sling (For Arm Injuries) • Use a triangular bandage or a large cloth. • Keep the hand slightly elevated above the elbow. 4. Manage Shock • Lay the person down, keep them warm with a blanket, and elevate their legs (unless a leg, hip, or spine injury is suspected). 5. Comfort and Reassure • Stay with the person until help arrives. • Keep them calm and still. What NOT To Do (Critical Mistakes) • DO NOT straighten or “reset” the bone. • DO NOT move the person unnecessarily, especially if a head, neck, or spinal injury is suspected. • DO NOT give food or drink (in case surgery is needed). • DO NOT apply a tourniquet unless trained and bleeding is uncontrollable. • DO NOT tie bandages tightly over the fracture site. Summary: Key Priorities at the Scene 1. Call emergency services. 2. Do not move the victim. 3. Control bleeding (for open fractures). 4. Immobilize the injured area with a splint or sling. 5. Treat for shock and provide reassurance. Professional medical care—including X-rays, casting, or surgery—will be provided by emergency responders and hospital staff. Your role at the scene is to provide essential first aid to prevent further injury. Talib Chichan Al-Mustaqbal University The First University in Iraq